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NPI Code Detail

MEDICARE: ROBERT L. EBERLE M.D.

MEDICARE: ROBERT L. EBERLE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician200611-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1962407205
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT L. EBERLE M.D.
Provider Business Mailing Address
First Line : PO BOX 1766
Second Line : 165 OAK STREET
City : PLATTSBURGH
State : NY
Zip : 12901-0240
Country : US
Telephone Number : 518-852-9871
Fax Number :
Provider Business Practice Location Address
First Line : 75 BEEKMAN ST
Second Line :
City : PLATTSBURGH
State : NY
Zip : 12901-1438
Country : US
Telephone Number : 518-561-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2005
Last Update Date : 07/08/2007

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